I need to find out more about Kolkata's public doctors and state hospitals Tomorrow I will ask one of the medical team who live on the floor below. I have moved rooms. Now I am staying in a hostel just for long term volunteers. We have a cheaper rate and filtered water. The majority seem to be working in health care, so I have just the abundance of resources which I need to answer the questions of today:
Today I worked my second shift at a small clinic in Topsia village. Topsia is a Muslim village about 30 minutes by taxi from Sudder Street. It is also at the edge of an urban slum area and incredibly poor. The clinic is a relatively new venture (two years old) and staffed by an Australian Nurse and his team. Now I have no medical training what so ever. Unless of course you count my PADI Emergency First Aid. But I don't; so far my knowledge of CPR and the maximum participant-to-mannequin ratio has had zero relevance. However, the Nurse who I worked alongside was very forgiving and welcomed the extra pair of hands. As I have reiterated before – I am not a health care practitioner. I am not 'good' at dealing with the sickness; especially someone else's. However, after nearly two weeks surrounded by physical suffering, I decided it was about time to grow up and face the physical limitations of the human body – illness and disease. Besides, I was as 'qualified' as the next volunteer – which meant physically able and with time to donate.
The Nurse has decided to dedicate five years to community health care here in Kolkata by initiating a series of grass-roots projects. These include providing food to 30 members of the local community every day, providing hearing tests for children suspected of having learning difficulties due to ear trauma (courtesy of the combination of filthy water, lack of infrastructure, sewage treatment and waste disposal), and sponsoring his Indian staff to receive nursing training, teacher training and English lessons. In regards to Topsia clinic; it is very basic and yet works to try and fill the vital gap between the national health service and community medicine. The tiny room has one plastic table, two chairs, two stools, a kettle for boiling hot water, a backpack full of cleaning agents, local antibiotics, ear drops, bandages, tweezers, pincers, scissors, thermometers, as well as two little devices for testing iron levels and blood sugar levels respectively. Today it also contained one Nurse, one Indian Assistant and once again – one Me.
Outside queued tiny tots carried by concerned mothers, sick fathers missing work, anemic grandmothers and scabies covered children. The clinic officially opens from ten o'clock until noon, but today the stream of sick seemed infinite. The Nurse told me that word was spreading, so popularity was increasing. However, he also said that the severity of the cases they were treating was decreasing. Two years ago it was not uncommon for people near to death to visit him, and now it is not so common. The Nurse is a nurse. He is not a doctor. And the community clinic is a clinic and not a hospital. The Nurse will hand out antibiotics for ear, skin or chest infections but for anything more serious recommendations are written on pieces of paper, and with the help of the Indian assistant, the patient is asked to seek out the local doctor.
This morning at Topsia clinic I saw for myself the combined dangers of being both sick and poor.
About half way through the morning when the days humidity was approaching its climax, and the stream of patients had overflowed to line the walls, the Nurse asked me to dress the leg of Ali. Ali had been in a motorbike accident about eight months ago. Now he received hospital treatment and one of his two broken bones had been pinned back together. The other was not. Six to seven months later Ali appeared at the clinic. The Nurse recalled, “the maggots feeding on his leg were keeping it clean, but they were also making the wound larger.” As the Nurse peered into a little boys leaking ears, I soaked a cotton bud in dettol and carefully began to remove the dressing. Fear building up in me as each layer was removed. Finally, I pulled back the soggy layer padding the enormous crater in his shin. The Nurse leaned over. “Ah, its healing nicely!” I looked up at Ali. He smiled back at me. I tried to remain focused. Its only a leg. I reassured myself. I have one. I repeated. Its just that I can't see the bone when I look at mine. The other voice in my head replied.
The hole I had to clean was so deep. Sure enough the new pink skin was slowly healing, but there was a large piece of brown tibia protruding. A clear reminder that we are all just skin and bones: Easily broken - and not necessarily always easily fixed. My job was to scrape off the yellow scabs forming along the edges of the wound, clean and then re-dress. I was scared to cause him more pain. But my shock at his own injury brought the required focus. I dragged the blade across new flesh and wiped it on a cotton bud. I was proud of myself. How ridiculous! It wasn't my bone that was poking out of my leg. I looked up at Ali again. He smiled back at me, again.
The second patient who remains in my mind is a little tennis super star who arrived into the clinic as 'just another boy' with a head full of scabies. The 'just another boy' is aged six. He appeared silently, removing his little topi to reveal infected lumps oozing with yellow puss. He was the bravest little tennis super star I have ever had the pleasure to meet. It was my first time to remove the infected lumps which rose up from underneath his scalp, and I am sure my clumsy technique left much to be desired, but he didn't whimper once. He just remained seated, back straight and topi clenched between his little lumpy hands. This little hero walked out of the clinic looking like a little tennis super star – white bandage wrapped around his head, as the women waiting at the door chastised him for self-consciously trying to replace his faithful topi.
And this is what Topsia clinic does; it provides a service which the poor cannot afford, but which the poor need the most. And this is why I am amazed that the state hospitals and government doctors seem to by-pass the poor, despite apparent policies to the contrary. Why the need for Topsia Clinic? Why are the destitute taken to the Mother Houses of the Mission of Charity, where they receive only the most basic of medical care? Why are patients operated on and then walk out with bones still trying to escape from skin and skin ripe to feed maggots? Why are educated mothers producing brave little boys with heads full of parasites?
We dismantle the clinic and carry the medicines through the narrow alleyways. Behind us echo the pattering steps of little feet. Mister Mister! The Nurse turns around to be greeted by a Witch Doctor. He is shimmying his grass skirt and jingling his array of threaded shells.
“Whats this!” Asks the Nurse?
“Ah Mister there is a fancy dress competition at school today” replies the painted white face poking out from his crown of leaves.
I smile. Perhaps my little tennis super star won't have such a bad afternoon after all.
Today I worked my second shift at a small clinic in Topsia village. Topsia is a Muslim village about 30 minutes by taxi from Sudder Street. It is also at the edge of an urban slum area and incredibly poor. The clinic is a relatively new venture (two years old) and staffed by an Australian Nurse and his team. Now I have no medical training what so ever. Unless of course you count my PADI Emergency First Aid. But I don't; so far my knowledge of CPR and the maximum participant-to-mannequin ratio has had zero relevance. However, the Nurse who I worked alongside was very forgiving and welcomed the extra pair of hands. As I have reiterated before – I am not a health care practitioner. I am not 'good' at dealing with the sickness; especially someone else's. However, after nearly two weeks surrounded by physical suffering, I decided it was about time to grow up and face the physical limitations of the human body – illness and disease. Besides, I was as 'qualified' as the next volunteer – which meant physically able and with time to donate.
The Nurse has decided to dedicate five years to community health care here in Kolkata by initiating a series of grass-roots projects. These include providing food to 30 members of the local community every day, providing hearing tests for children suspected of having learning difficulties due to ear trauma (courtesy of the combination of filthy water, lack of infrastructure, sewage treatment and waste disposal), and sponsoring his Indian staff to receive nursing training, teacher training and English lessons. In regards to Topsia clinic; it is very basic and yet works to try and fill the vital gap between the national health service and community medicine. The tiny room has one plastic table, two chairs, two stools, a kettle for boiling hot water, a backpack full of cleaning agents, local antibiotics, ear drops, bandages, tweezers, pincers, scissors, thermometers, as well as two little devices for testing iron levels and blood sugar levels respectively. Today it also contained one Nurse, one Indian Assistant and once again – one Me.
Outside queued tiny tots carried by concerned mothers, sick fathers missing work, anemic grandmothers and scabies covered children. The clinic officially opens from ten o'clock until noon, but today the stream of sick seemed infinite. The Nurse told me that word was spreading, so popularity was increasing. However, he also said that the severity of the cases they were treating was decreasing. Two years ago it was not uncommon for people near to death to visit him, and now it is not so common. The Nurse is a nurse. He is not a doctor. And the community clinic is a clinic and not a hospital. The Nurse will hand out antibiotics for ear, skin or chest infections but for anything more serious recommendations are written on pieces of paper, and with the help of the Indian assistant, the patient is asked to seek out the local doctor.
This morning at Topsia clinic I saw for myself the combined dangers of being both sick and poor.
About half way through the morning when the days humidity was approaching its climax, and the stream of patients had overflowed to line the walls, the Nurse asked me to dress the leg of Ali. Ali had been in a motorbike accident about eight months ago. Now he received hospital treatment and one of his two broken bones had been pinned back together. The other was not. Six to seven months later Ali appeared at the clinic. The Nurse recalled, “the maggots feeding on his leg were keeping it clean, but they were also making the wound larger.” As the Nurse peered into a little boys leaking ears, I soaked a cotton bud in dettol and carefully began to remove the dressing. Fear building up in me as each layer was removed. Finally, I pulled back the soggy layer padding the enormous crater in his shin. The Nurse leaned over. “Ah, its healing nicely!” I looked up at Ali. He smiled back at me. I tried to remain focused. Its only a leg. I reassured myself. I have one. I repeated. Its just that I can't see the bone when I look at mine. The other voice in my head replied.
The hole I had to clean was so deep. Sure enough the new pink skin was slowly healing, but there was a large piece of brown tibia protruding. A clear reminder that we are all just skin and bones: Easily broken - and not necessarily always easily fixed. My job was to scrape off the yellow scabs forming along the edges of the wound, clean and then re-dress. I was scared to cause him more pain. But my shock at his own injury brought the required focus. I dragged the blade across new flesh and wiped it on a cotton bud. I was proud of myself. How ridiculous! It wasn't my bone that was poking out of my leg. I looked up at Ali again. He smiled back at me, again.
The second patient who remains in my mind is a little tennis super star who arrived into the clinic as 'just another boy' with a head full of scabies. The 'just another boy' is aged six. He appeared silently, removing his little topi to reveal infected lumps oozing with yellow puss. He was the bravest little tennis super star I have ever had the pleasure to meet. It was my first time to remove the infected lumps which rose up from underneath his scalp, and I am sure my clumsy technique left much to be desired, but he didn't whimper once. He just remained seated, back straight and topi clenched between his little lumpy hands. This little hero walked out of the clinic looking like a little tennis super star – white bandage wrapped around his head, as the women waiting at the door chastised him for self-consciously trying to replace his faithful topi.
And this is what Topsia clinic does; it provides a service which the poor cannot afford, but which the poor need the most. And this is why I am amazed that the state hospitals and government doctors seem to by-pass the poor, despite apparent policies to the contrary. Why the need for Topsia Clinic? Why are the destitute taken to the Mother Houses of the Mission of Charity, where they receive only the most basic of medical care? Why are patients operated on and then walk out with bones still trying to escape from skin and skin ripe to feed maggots? Why are educated mothers producing brave little boys with heads full of parasites?
We dismantle the clinic and carry the medicines through the narrow alleyways. Behind us echo the pattering steps of little feet. Mister Mister! The Nurse turns around to be greeted by a Witch Doctor. He is shimmying his grass skirt and jingling his array of threaded shells.
“Whats this!” Asks the Nurse?
“Ah Mister there is a fancy dress competition at school today” replies the painted white face poking out from his crown of leaves.
I smile. Perhaps my little tennis super star won't have such a bad afternoon after all.
1 comment:
Hey, Bex,
what a surprise, I was googling Topsia and stumbled upon your blog. Nice description of the Topsia clinic. I've been trying to call you. Give me a call or email me if you're in Kolkata kasnate@gmail.com.
Elena
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